title: Prenatal, perinatal and neonatal risk factors of Autism Spectrum Disorder: a comprehensive epidemiological assessment from India.
abstract: Incidence of Autism Spectrum Disorder (ASD) is increasing across the globe and no data is available from India regarding the risk factors of ASD. In this regard a questionnaire based epidemiological assessment was carried out on prenatal, perinatal and neonatal risk factors of ASD across 8 cities in India. A retrospective cohort of 942 children was enrolled for the study. 471 children with ASD, under age of 10, were analyzed for pre-, peri-, and neonatal factors and were compared with the observations from equal number of controls. The quality control of the questionnaire and data collection was done thoroughly and the observations were computed statistically. A total of 25 factors were evaluated by unadjusted and adjusted analysis in this study. Among the prenatal factors considered, advanced maternal age, fetal distress and gestational respiratory infections were found to be associated with ASD and had an odds ratio of 1.8. Evaluation of perinatal and neonatal risk factors showed labor complications, pre-term birth, neonatal jaundice, delayed birth cry and birth asphyxia to be associated with ASD with an odds ratio greater than 1.5. This important study, first of its kind in Indian population gives a firsthand account of the relation of pre-, peri- and neonatal risk factors on ASD from an ethnically and socially diverse country like India, the impact of which was unknown earlier. This advocates additional focused investigations on physiological and genetic changes contributed by these risk factor inducing environments.
authors.affiliation: Department of Biological Sciences, BITS, Pilani - Hyderabad Campus, Jawaharnagar, Shamirpet (M), Hyderabad 500078, Andhra Pradesh, India.
authors.forename: Madhu Poornima
authors.initials: MP
authors.lastname: Mamidala
authors.forename: Anupama
authors.initials: A
authors.lastname: Polinedi
authors.forename: Praveen Kumar
authors.initials: PK
authors.lastname: P T V
authors.forename: N
authors.initials: N
authors.lastname: Rajesh
authors.forename: Omsai Ramesh
authors.initials: OR
authors.lastname: Vallamkonda
authors.forename: Vrajesh
authors.initials: V
authors.lastname: Udani
authors.forename: Nidhi
authors.initials: N
authors.lastname: Singhal
authors.forename: Vidya
authors.initials: V
authors.lastname: Rajesh
mesh_terms: D000328:Adult; D001238:Asphyxia Neonatorum / Q000453:epidemiology*; D001724:Birth Weight; D016022:Case-Control Studies; D002659:Child Development Disorders, Pervasive / Q000453:epidemiology*; D005260:Female; D006801:Humans; D007194:India / Q000453:epidemiology; D007231:Infant, Newborn; D007567:Jaundice, Neonatal / Q000453:epidemiology; D008297:Male; D008423:Maternal Age; D010290:Parents; D010331:Paternal Age; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology*; D047928:Premature Birth / Q000453:epidemiology; D011297:Prenatal Exposure Delayed Effects / Q000453:epidemiology*; D012307:Risk Factors; D011795:Surveys and Questionnaires
keywords: ASD; Autism Spectrum Disorder; CARS; CI; Childhood Autism Rating Scale; DSMIV; Diagnostic and Statistical Manual of Mental disorders IV; ICD-10; India; International Classification of Diseases-10; Neonatal; OR; P; Perinatal; Prenatal; Risk factors; confidence intervals; odds ratio; probability value